Retinal detachment is a separation of the retina, which is the light-sensitive layer in the back of the eye from its outer layers. The retina is a transparent membrane in the back of the eye. It helps you see the images that are focused on it by the cornea and the lens. Retinal detachments are often associated with a tear or hole in the retina through which eye fluids may leak into the sub-retinal space. This causes separation of the retina from the underlying layers.If not treated early, retinal detachment can cause permanent vision loss.
There are three different types of retinal detachments:
Retinal detachment often occurs on its own without an underlying cause. However, it may also be caused by trauma, diabetes, and inflammatory disorders. It is most often caused by a related condition called posterior vitreous detachment (PVD). During a retinal detachment, bleeding from small retinal blood vessels may fill the inside of the eye, which is normally filled with vitreous fluid. Central vision becomes severely affected if the macula, the part of the retina responsible for fine vision, becomes detached.
A retinal detachment can occur at any age, but it is more common in people over age 40. A retinal detachment is also more likely to occur in people who:
Symptoms include a sudden or gradual increase in either the number of floaters, which are little "cobwebs" or specks that float about in your field of vision, and/or light flashes in the eye. Another symptom is the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.
Small holes and tears are treated with laser or cryopexy. These procedures are usually performed in the clinic as an outpatient procedure. With a laser, tiny scars are made around the hole to "weld" the retina back into place. Cryopexy freezes the area around the hole and helps reattach the retina. These procedures are done for early onset cases or those without detachment as a preventive measure.
Retinal detachments are generally treated with surgery. In some cases a scleral buckle, a silicon band, is sutured to the eyeball from the outside to gently indent the wall of the eye against the detached retina. Avitrectomysurgery may also be performed in a large number of cases. Here, 3 tiny incision in the sclera (white of the eye) are made to gain access to the vitreous. Next, a small instrument called a cutter is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain its shape. Air and Gas is injected to into the eye to replace the vitreous and reattach the retina; the gas pushes the retina back against the wall of the eye. During the healing process, the eye secretes the fluid that gradually replaces the gas and fills the eye. With all of these procedures, either laser or cryopexy is used to stick the retina back in place. Silicon Oil is used in some cases with advanced problems like large or giant tears and proliferative retinopathy.
With these latest procedures, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second surgery is needed. However, the final visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact a specialist immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.
Tests will be done to check the retina and pupil response and your ability to see colors properly. These may include:
The unsuccessful reattachment of the retina might be a result of formation of new/ fresh breaks in the retina, scarring or membrane formation, uncontrolled swelling of the retina and choroid, uncontrolled eye pressure and inflammation. These could be one of the reasons for recurrence and loss of vision.
What happens will depend on the location and extent of the detachment, history of previous eye surgeries and early treatment. If the macula has not detached, the results of treatment can be excellent. Most retinal detachments can be repaired, but not all of them. The exact prognosis can be determined only after a thorough eye examination.
Use protective eye wear to prevent eye trauma. Control your blood sugar carefully if you have diabetes. See your eye care specialist at least yearly, especially if you have risk factors for retinal detachment like myopia or family history of retinal problems.